Milk and Other Drinks

All your baby needs for optimum nutrition up to six months old is breastmilk. For the first year it continues to be a primary source of nourishment and because of this milk needs to be given before solids until around 8 or 9 months. Cow’s milk is low in iron and other vitamins and minerals necessary for baby’s growth and is not suitable as a main drink for the first year.

Water

When your baby is thirsty water is the best supplement for breastmilk.

Water is important when:

• the weather is very hot
• baby has a temperature or fever
• baby is vomiting or has diarrhoea

Boil bottled water.  You have no guarantee that it is any purer than tap water. Up to six months – continue to boil and cool the water first if there are concerns about the quality of the town water supply. Up to 18 months – boil tank or bore water. Contact your local District Council if you have questions about the quality of your water supply.

Caffeine drinks and alcohol

Caffeine is a stimulant, which can be harmful to your baby. Caffeine-containing drinks are tea, coffee, cocoa and cola drinks. Tea also contains tannin which reduces the absorption of iron. Iron is vitally important for baby’s brain development and learning. Herbal teas are not recommended as not enough is known about their safety although their tannin content is lower. Alcohol is a poison and should never be given to babies.

Sugary Drinks

The high sugar content of fruit juice, fizzy drinks, flavoured milk, packet and other fruit drinks can damage your baby’s teeth. If it is well diluted, enough to just flavour the water, fruit juice may be given for its vitamin C content.

Prevent tooth decay by:

• avoiding letting baby regularly fall asleep while drinking
• avoiding frequent sweet drinks.

Introduction of Complementary feeding

Birth weight triples in the first twelve months and while breastmilk or formula provides all your baby’s nutritional needs for the first six months, solids need to be introduced to meet growing developmental needs such as chewing. By six months baby needs more energy than is provided by milk alone, along with more iron and higher amounts of vitamins and other minerals.

When to Start

There is no set time to begin introducing complementary feeding though around 6 months is usual. Solid foods cannot be tolerated before 4 months because baby’s digestive system is still developing.  If solid food is given too early there is a risk of choking, putting a strain on young kidneys, and infections and allergies developing.  Unless baby is ready, it is not necessarily true that starting solids will result in better sleep patterns.  Your baby will let you know the right time.

Some of the signs of being ready are:

• seeming to be increasingly hungry after milk feeds
• showing interest in your food and reaching for it
• putting things in the mouth (hands and toys)
• good head control
• opening the mouth when you offer food from a spoon
• being able to take food from a spoon and swallow it instead of pushing the spoon and food out with the tongue

Now the Fun Begins!

Starting your baby on solid food is an adventure for you both. Baby is being introduced to strange new tastes and textures. You will be trying to prepare enticing and healthy foods for baby which take time and thought. Sometimes your offerings will be happily accepted and other times be roundly refused or spat out. Don’t take it personally. Try again another time and allow baby the time to acquire new tastes.

First foods

• baby rice or iron-fortified infant cereal (check the labels for the age they suit) made with breastmilk
• cooked and puréed vegetables – kumara, potato, carrot, pumpkin, marrow, avocado
• puréed fruit – cooked apple, pear, ripe banana, peach, apricot
• prepared frozen or canned baby foods (check the labels for the age they suit)

Preparing Solids

Baby’s first foods need to be pureed until easy to swallow. A blender or mouli, or fine sieve can be used to make the food smooth and runny. Soften or dilute with breastmilk. At this stage avoid using cow’s milk or butter. Diluting with water, unless it is the water used for cooking the vegetables or fruit, will dilute the nutritional value. It is unnecessary to add sugar or salt. Baby’s taste buds are very sensitive. What’s bland to you will not be to your baby.

Heating food and food safety

• Always test the temperature of food to avoid burning baby’s mouth. Test by putting the back of the spoon used to stir baby’s food, on the inside of your wrist. It should be just warm, not hot.
• Use a separate clean spoon for feeding.
• Frozen food must be well heated and then cooled.
• If you choose to use a microwave for heating your baby’s food, be sure to stir and leave for at least 2-3 minutes to cool down before serving it. The food is still cooking when the oven has stopped.
• Don’t keep leftovers. Food poisoning can result from reheating food. A good idea is to cook a large amount, then freeze baby sized meals in small containers or ice cube trays. Then you can defrost just enough for one meal at a time.

How to start

• Choose a time when you and baby are relaxed and there aren’t a lot of distractions (perhaps around lunchtime or early afternoon), and you can have a happy time together. Remember that this introduction to solids is more about the experience than nutrition.
• So that baby can feel secure it may help to hold him as you do while giving the milk feed.
• Give all or most of the milk feed first.
• Then offer baby a teaspoon of the slightly warm, smooth, runny food. Once a day is enough at first.
• Let baby taste the food and suck it off the spoon.
• At first she may spit the food out while she is learning the new skill of moving it to the back of her mouth for swallowing. Usually, it takes a week or so for babies to become better at taking food from a spoon.
• If baby spits out a food repeatedly, try another food instead next time. Then offer the rejected food again after a few days.
• Babies may prefer some tastes more than others (like their mums and dads). Try mixing a small amount of refused food with a food she enjoys. You can gradually increase the proportion. Sometimes a new food takes many tries before it is accepted so don’t give up; unless your baby reacts to the food (e.g. becomes unsettled with wind).
• In this case, stop the food and try it again in a few weeks. Don’t assume it is a food allergy, it probably isn’t.

How much and how often?

Every baby is different, but here are a few tips:

• Start with a small amount of food once a day and gradually increase to about half a cup before increasing the number of meals per day. Carry on increasing the amount according to baby’s appetite. Some babies eat more than others.
• Experiment with one food at a time and wait for 4-5 days before trying new food.

Your baby may eat all you offer at mealtime or stop quickly when she has had enough. She will let you know she is finished by:

• Turning her head away
• Pushing the food or your hand away
• Closing her mouth and/or crying
• If your baby is really not interested, take the food away. Mealtimes should be enjoyable and your child should not be forced to eat.

What’s next? (6 – 7 months)

When your baby is established on some first foods, try new foods to introduce with different flavours and textures. To help develop baby’s chewing mash soft foods with a potato masher or fork, allowing some lumpiness. Now you can try offering food more often, up to 2-3 times a day.

New foods to try:

• fruits – melon, nectarine, plums, nashi pears
• vegetables – courgettes, broccoli, cauliflower, puha, watercress, yams, taro, parsnips, green beans
• meat – beef, lamb, liver, kidney, chicken – all pureed at first
• cooked egg yolk
• rusks, toast, crackers
• wheat and oatmeal infant baby cereal

Why does my baby need iron?

Your baby needs more iron foods now because the stores of iron she had at birth will have been used up. Iron is extremely important for her brain development and learning, and to maintain her energy. Beef, lamb, chicken and liver are the best iron-rich foods for your baby at this time are. Iron in meat is easier to use than the iron found in vegetables and cereal, and red meat contains more iron than white meat. Cook the meat then puree or chop finely. If it needs to be softened you can add vegetable water or juice from the meat.

Iron-rich tip:

Keep some lamb’s liver or kidney (particularly rich sources of iron) in the freezer and, as needed, grate off a small amount. Poach until cooked through and add to your baby’s vegetables. Offer meat 3-5 times a week. (Liver is rich in vitamin A, and while good for health, too much can be harmful. Limit it to about three teaspoons a week.)

Avoid the following foods at this stage:

• cow’s milk and other dairy products (cheese, yoghurt, custard)
• egg white
• fish and seafood
• soy foods and milk
• citrus fruits

The Main Course at 8-9 months

Around 8-9 months it is time to start offering solids before breast or formula milk as the main course. Food now is more important for its nutritional value rather than a simple exploration of taste and texture.

Your baby can enjoy a large variety of foods now:

• vegetables and fruits
• meat, fish
• cereals, rice, pasta
• yoghurt, cheese, custard, ice cream
• peas and beans, including baked beans and cooked kidney beans, lentils (legumes), soy foods (e.g. tofu)
• white bread, plain crackers

Baby’s biting and chewing skills and her delight in exploring are stimulated by a greater variety of foods especially finger foods, which give her a sense of independence. She will love feeding herself. You can try:

• chunks of ripe fruit – banana, peach, pear, and orange
• pieces of meat
• grated or cubed cheese
• fingers of bread, rusks or chappati
• pieces of cooked vegetables

She will also love dropping food over the side of her high chair and watching it fall. This is normal! Spread plastic under the highchair to contain the mess! Bear in mind that towards the end of a meal, dropping food may also signal your baby is no longer hungry.

Safety Tips:

These are a few precautions to ensure meals remain safe and enjoyable as your baby becomes more independent with her eating:

• stay with your baby when she is eating.
• ensure she is sitting down when eating to reduce the danger of choking.
• avoid small hard foods, such as nuts, which can cause her to choke.

Not yet:

• Cow’s milk as a drink and egg white are best left until one year of age.
• High fibre foods, e.g. wholemeal bread and bran, are best left until your baby is two years old. Because they are very filling little room is left in your baby’s small stomach for other nourishing foods.
• If you have a strong family history of allergies, delay the introduction of dairy foods, eggs and fish until after 12 months of age.
• A family history of peanut allergies indicates peanuts should be excluded altogether from your child’s diet until at least 3 years of age. This will reduce the chances of her having a severe reaction.

If you elect to give your baby a vegetarian diet, you may like to discuss your baby’s need for certain vitamins and minerals (in particular iron and vitamin B12) with your health professional or discuss seeing a dietitian.

A love of vegetables:

If you are serious about giving your child the best start in life, a really simple and practical thing you can do is to eat a lot of vegetables.

“So why should I eat lots of vegetables?” you ask when it is the children whose eating we are focusing on? Simple… if you lead by example, eventually they will follow! Vegetable eating is best when it is part of your family lifestyle – just like cleaning teeth, having a shower, or wearing a seatbelt. The best philosophy is eating vegetables and making sure we get our 5+ a day is just something our family does. No debate.

In the greater scheme of things a love of vegetables is indeed a phenomenally awesome gift. Once established, this will be with them for their lifetime and will set them on a path of a long, healthy and happy lifestyle. Many children who don’t get good eating habits established ‘at the beginning’ are destined to a life of diets, struggling with their weight, or ill health. Put bluntly they are disadvantaged because they don’t give their bodies the sort of fuel that will make them perform at optimal levels.